Abdominal Examination in NHS for OSCE

 

Abdominal Examination in NHS for OSCE

The abdominal examination is an essential skill that medical students and healthcare professionals need to learn to perform confidently and competently. In the United Kingdom, the National Health Service (NHS) OSCE (Objective Structured Clinical Examination) often includes an abdominal examination as a part of its assessment. In this blog, we will provide a step-by-step guide for performing an abdominal examination for the NHS OSCE.

Step 1: Introduction and Preparation Before beginning the examination, introduce yourself to the patient, explain the procedure, and obtain their consent. Ask the patient to lie flat on their back with their arms by their sides, and their knees bent. Make sure you have adequate lighting and a clean, quiet examination area. Wash your hands and put on disposable gloves.

Step 2: Inspection Begin by visually inspecting the abdomen for any signs of distention, masses, or scars. Observe the skin for rashes, ecchymosis, or surgical scars. Look for any visible peristalsis, which may indicate bowel obstruction.

Step 3: Auscultation Using a stethoscope, auscultate the abdomen in all four quadrants, listening for bowel sounds. Start from the right lower quadrant and move clockwise to the other quadrants. Note the frequency, intensity, and character of the sounds. Absent or decreased bowel sounds may suggest ileus or bowel obstruction.

Step 4: Percussion Percuss the abdomen to assess the size, shape, and density of the organs. Start with light percussion and then move to deeper percussion. A dull sound may indicate an enlarged liver, spleen, or full bladder. A tympanic sound may suggest bowel distention.

Step 5: Palpation Palpate the abdomen in all four quadrants using your fingertips. Start with light pressure and then gradually increase the pressure to assess for tenderness, masses, or organ enlargement. Note any pain, rebound tenderness, or guarding. Assess for liver and spleen enlargement, and palpate the bladder for distension.

Step 6: Special Tests Perform any special tests that are required, such as McBurney's point tenderness for appendicitis, Murphy's sign for cholecystitis, or the heel tap test for peritonitis.

Step 7: Summary and Closure Once you have completed the examination, summarize your findings to the patient, and answer any questions they may have. Thank the patient, and offer them the opportunity to provide feedback on their experience.

In conclusion, the abdominal examination is a vital skill that medical students and healthcare professionals need to learn to perform competently. By following these step-by-step guidelines, you can perform an abdominal examination confidently and accurately during your NHS OSCE. Remember to introduce yourself, obtain consent, prepare the patient, inspect, auscultate, percuss, palpate, perform special tests, and summarize your findings to complete the examination successfully.

 

Dr.Muhammad Arsalan Khan
Diabetes Specialist
MBBS, MSc (Diabetes & Endocrinology)
CCD-BMJ-A K U-RCP (London)